Wednesday, December 19, 2007

[EQ] Season's greetings from EQUITY & Health listserv Team!

 

 

Season's greetings from EQUITY & Health listserv Team!

We’d like to express our appreciation for your input and participation in     
Equity, Health and Human Development Listserver during the year 2007.

Our current operations will be suspended for the holidays and will begin again
on the 14th January, 2008.

Wishing you every joy and prosperity in the coming year.

Information Knowledge Management Area – DD/IKM
Pan American Health Organization / World Health Organization

 


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Tuesday, December 18, 2007

[EQ] The Health Systems Assessment Approach: A How-To Manual

            The Health Systems Assessment Approach: A How-To Manual

Mursaleena Islam, Editor, 2007
U.S. Agency for International Development in collaboration with Health Systems 20/20, Partners for Health Reformplus, Quality Assurance Project, and Rational Pharmaceutical Management Plus. Arlington, VA: Management Sciences for Health

Available online as PDF file [374p.] at: http://healthsystems2020.org/files/528_file_Manual_Complete.pdf

“……This approach is designed to provide a rapid and yet comprehensive assessment of key health systems functions. The approach is organized around technical modules that guide data collection, and cover the following areas—

• Governance

• Health financing

• Health service delivery

• Human resources

• Pharmaceutical management

• Health information systems


Each module provides guidance for the user according to an indicator-based approach. The assessment approach is flexible and may encompass all modules for a more comprehensive view of the health care system or may focus on selected modules, according to the objectives of the assessment. A required core module provides basic background information on a country’s key health indices and other important data related to its economy, health system organization, and

population. ….”

Download the Manual by Chapter

 

Introduction http://healthsystems2020.org/files/570_file_00_Introduction.pdf


Chapter 1.
Health Systems Strengthening: An Introduction
http://healthsystems2020.org/files/571_file_01_Chapter_1.pdf

 

Chapter 2. Overview of the Approach
http://healthsystems2020.org/files/572_file_02_Chapter_2.pdf

 

Chapter 3. Planning and Conduction the Assessment

http://healthsystems2020.org/files/573_file_03_Chapter_3.pdf

 

Chapter 4. Synthesizing Findings and Developing Recommendations
http://healthsystems2020.org/files/574_file_04_Chapter_4.pdf

 

Chapter 5. Core Module
http://healthsystems2020.org/files/575_file_05_Chapter_5.pdf

 

Chapter 6. Governance Module
http://healthsystems2020.org/files/576_file_06_Chapter_6.pdf

 

Chapter 7. Health Financing Module
http://healthsystems2020.org/files/577_file_07_Chapter_7.pdf

 

Chapter 8. Health Service Deilvery Module
http://healthsystems2020.org/files/578_file_08_Chapter_8.pdf

 

Chapter 9. Human Resources Module
http://healthsystems2020.org/files/579_file_09_Chapter_9.pdf

 

Chapter 10. Pharmaceutical Management Module
http://healthsystems2020.org/files/580_file_10_Chapter_10.pdf

 

Chapter 11. Health Information System Module
http://healthsystems2020.org/files/581_file_11_Chapter_11.pdf

 

 

 

 


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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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[EQ] Can working with the private for-profit sector improve utilization of quality health services by the poor?

Can working with the private for-profit sector improve utilization of quality health services by the poor?
A systematic review of the literature

 

Edith Patouillard1, Catherine A Goodman1,2, Kara G Hanson1, Anne J Mills1

1.Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine, London, UK

2.Kenya Medical Research Institute / Wellcome Trust Research Programme, Nairobi, Kenya
International Journal for Equity in Health – November 2007

 

Available online as PDF file [36p.] at: http://www.equityhealthj.com/content/pdf/1475-9276-6-17.pdf

 

“…..There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations.

 

This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor.

 

Methods

The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out.

 

The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations

 

Results

A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions.


Conclusions

Few studies provided evidence on the impact of private sector interventions on quality and/or utilization of care by the poor. It was, however, evident that many interventions have worked successfully in poor communities and positive equity impacts can be inferred from interventions that work with types of providers predominantly used by poor people. Better evidence of the equity impact of interventions working with the private sector is needed for more robust conclusions to be drawn…..”

 



*      *      *     * 

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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[EQ] Reaching for a Healthier Life - Facts on Socioeconomic Status and Health in the US

Reaching for a Healthier Life
Facts on Socioeconomic Status and Health in the U.S.


Nancy Adler (director) and Judith Stewart (network administrator) with Sheldon Cohen, Mark Cullen, Ana Diez Roux, William Dow,
Gary Evans, Ichiro Kawachi, Michael Marmot, Karen Matthews, Bruce McEwen, Joseph Schwartz, Teresa Seeman and David Williams
.

John D and Catherine MacArthur Foundation - Research Network on Socioeconomic Status and Health, 2007-12-17

There are substantial disparities in health and longevity among different sectors of the US population. 
 Who suffers from poorer health and greater premature mortality?  How do these differences come about?  What can be done to eliminate these disparities?

Available online as PDF file [52p.] at: http://www.macses.ucsf.edu/News/Reaching%20for%20a%20Healthier%20Life.pdf

 

“……Reaching for a Healthier Life is the result of a decade of work by the MacArthur Foundation Research Network on SES & Health. This multidisciplinary group of scientists has examined the pathways by which socioeconomic status “gets into the body” to affect health and longevity.  There is no single pathway by which this occurs.  Rather, resources associated with where people stand on the social ladder shape multiple aspects of their lives in ways that affect their health and well-being. ……”

 

TABLE OF CONTENTS

Introduction

Fact 1: Social Status Matters for Health, from Birth to Death

Fact 2: Neighborhoods Matter

Fact 3: Employment Conditions Matter

Fact 4: Personal Behaviors Matter

Fact 5: Health Care Matters

Fact 6: Race Matters

Fact 7: Stress Matters

Fact 8: Our Bodies Pay the Price

Policy Implications

Reaching for a Healthier Life:  Synopsis

Key findings are:

 (1) The effects of socioeconomic status are substantial. They are not limited to the effects of poverty but occur at all levels. Premature death is more than twice as likely for middle income Americans as for those who are the best off, and more than three times as likely for those who live near or in poverty compared to the most privileged.

(2) Throughout life, from birth onward, our access to socioeconomic resources affects our chances for living a healthy life. The conditions we live in during childhood affect our health throughout our lives.

(3) Health care is important when we are ill but accounts for only a small portion of health disparities. More important are factors that determine if we fall ill in the first place.

(4) Each step up the social ladder provides greater access to social and physical environments that enable individuals to engage in health protective behaviors, (e.g., safe places to walk and access to healthier foods).

(5) Conditions at work can contribute to health and health disparities. Jobs held by those lower on the ladder are more likely to involve shift work and physical hazards, low control over how and when tasks are done, job insecurity, and conflicts between family obligations and work requirements.

(6) Exposure to extreme and prolonged stress,( “toxic stress”), is more common lower on the social ladder. Stressors that last a long time, like financial insecurity, interpersonal disputes, work-induced exhaustion, or chronic conflict are recorded in the body.

(7) The biological consequences of exposure to stress are not transitory; they are cumulative. The normal functioning of the cardiovascular, immune, metabolic and nervous systems is disrupted. This disruption is made worse by poor health habits molded by social and physical environments lacking health-promoting alternatives.

What can be done? 

Two kinds of policies are required to reduce premature death and eliminate health disparities:
1. Policies that impact income and wealth distribution, educational attainment and occupational mobility, and
2. Policies that buffer individuals from the damaging conditions of living below the top rungs.

Supporting educational attainment, assuring a living wage, reducing crime, increasing opportunities for control at work, banning sale of soft drinks and junk food in schools are just a few policies with health consequences.  Economic, education, labor and zoning policies are all health policies.

The facts contained in this document support the case that policies to support healthy living conditions for all citizens are needed. The cost of implementing such policies would be offset by subsequent savings through increased productivity and lower health case costs. The initial investment would be money well spent. The one thing we cannot afford to do is nothing.

Reaching for a Healthier Life is available electronically, or write the network office to request a hardcopy at michael.daluz@ucsf.edu or judith.stewart@ucsf.edu.

 

 


*      *      *     * 

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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Monday, December 17, 2007

[EQ] Improved Health System Performance through Better Care Coordination

Improved Health System Performance through Better Care Coordination

Maria M. Hofmarcher, Howard Oxley, and Elena Rusticelli

Health Working Papers, No. 30 – December 2007
Organisation for Economic Co-operation and Development - OECD

 

            Available online as PDF file [85p.] at: http://www.olis.oecd.org/olis/2007doc.nsf/ENGDATCORPLOOK/NT00005926/$FILE/JT03237930.PDF

 

“…This report attempts to assess whether -- and to what degree - better care coordination can improve health system performance in terms of quality and cost-efficiency.  Coordination of care refers to policies that help create patient-centred care that is more coherent both within and across care settings and over time. Broadly speaking, it means making health-care systems more attentive to the needs of individual patients and ensuring they get the appropriate care for acute episodes as well as care aimed at stabilising their health over long periods in less costly environments….”

 

“…….Interest in coordination of care issues is increasing. Targeted programmes appear to improve quality but evidence on cost-efficiency is inconclusive.
Care coordination would be facilitated by better information transfer and wider use of ICT The balance of resources going to ambulatory care may need to be reviewed.  New ambulatory care models need consideration. Care coordination may benefit from greater health-system integration ….”

 

Content:

Introduction

CHAPTER 1. COORDINATION OF CARE: ISSUES, OBJECTIVES AND PRACTICE

1.1 Why care coordination issues are receiving greater attention

1.2 Which health-care goals might be better achieved from improved care coordination?

1.3 Evidence on current care-coordination practices in survey countries.


CHAPTER 2. CONDITIONS FOR ACHIEVING BETTER CARE COORDINATION

2.1 More readily available information on patient health and on provider quality is needed

2.2 The capacity of ambulatory care providers’ to coordinate needs strengthening

2.3 Payment schemes need to be better aligned with system-wide objectives

2.4 Regulatory and administrative barriers to cooperation across sectors need to be reduced


CHAPTER 3. "TARGETED" CARE CO-ORDINATION PROGRAMMES AND POLICIES

3.1 Experience with targeted programmes: a cross-country overview

3.2 The impact of disease/case management programmes: a review of recent literature

3.3 Some tentative conclusions: quality improvements may come at a cost


CHAPTER 4. EXPERIENCE WITH COORDINATION OF CARE IN SELECTED OECD COUNTRIES

4.1. The United States

4.2. Germany

4.3. United Kingdom (England)

4.4. Lessons learned from country cases


CHAPTER 5. SOME AREAS FOR POLICY CONSIDERATION


BIBLIOGRAPHY

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
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and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
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[EQ] Present status and future strategy for medical research in Europe

 

Present status and future strategy for medical research in Europe

 

White Paper from the European Medical Research Councils - 2007

 

“….to strengthen and improve European medical research, which in turn will result in better healthcare and improved human welfare. If funding for medical research in Europe is doubled within the next 10 years, and this is combined with the implementation of “best practice” for collaboration and organisation of medical research, there will be major benefits for European society, with a better health, welfare and hospital treatment, and a thriving medical industry….”

 

Available online as PDF file [52p.] at:

http://www.esf.org/index.php?eID=tx_ccdamdl_file&p[file]=14135&p[dl]=1&p[pid]=3728&p[site]=European%20Science%20Foundation&p[t]=1198504987&hash=f76a743db47bed2271d01efeaa73edae&l=en

 

Website: http://www.esf.org/publications.html

 

Tool Box: “Best Practice” for medical research in Europe:

Primary goals:

• Strong basic research

• Strong clinical research

• Strong translational research: bringing basic research knowledge into clinical practice, and vice versa

   -- all three of the above being facilitated by interdisciplinary research and public– private partnerships


Tools to reach these goals: people

• Career track schemes with attractive possibilities for researchers taking advantage of co-funding strategy

• European Medical Scientific Training Programme (EMSTP) for physicians and scientists scaling up existing successful initiatives

• The highest level of research ethics, and no scientific misconduct


Tools to reach these goals: research infrastructure

• Investment in national and European research infrastructure – covering the whole range from laboratory equipment in basic
  science labs and research facilities in hospitals, to the largest pan-European infrastructures, as outlined in the ESFRI Roadmap

• Launch a call for proposals to directly support on a highly competitive basis a league of top performing biomedical research
  centres of excellence, integrated into regional clusters

• Post-genomic clinical medicine

• Intelligent and coordinated use of Information Technology (IT)

• EC and national regulatory issues for clinical research adapted to facilitate research


Tools to reach these goals: research funding

• Adequate research funding – distributed on the basis of scientific excellence and through peer review

• Common criteria and methods for the evaluation of research outcomes

 

Tools to reach these goals: societal means

• Globalisation and collaboration: sharing of research and results

• Public engagement about medical research and its possible impacts

• Preparedness for the future

 

 


*      *      *     * 

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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[EQ] Health Impact Assessment: A practical guide

Health Impact Assessment: A practical guide

 

Harris, P., Harris-Roxas, B., Harris, E., & Kemp, L.

Sydney: Centre for Health Equity Training, Research and Evaluation (CHETRE)

Part of the UNSW Research Centre for Primary Health Care and Equity

The University of New South Wales, Australia UNSW -2007

 

The guide aims to provide people a practical understanding of HIA, its process, concepts and theories.

 

Available online as PDf file [43p.] at: http://www.hia2007.com/Health_Impact_Assessment_A_Practical_Guide.pdf

 

“…..Health Impact Assessment HIA is both a health protection and health promotion tool. In Health Impact Assessment HIA, health should be broadly defined to include assessments of both health hazards and health benefits of a proposal and the potential ways in which health and wellbeing can be both protected and promoted….”

 

Table of Contents

Foreword

Introduction

PART One: Overview of Key Concepts

What is HIA?

Why undertake HIA?

What do we mean by ‘health’?

How is health created?

What are health impacts?

HIA is prospective

Broad participation

Equity

PART Two: The Steps in HIA

1. Screening

2. Scoping

3. Identification

4. Assessment

5. Decision-making and recommendations

6. Evaluation and follow-up

Glossary of Terms

References

Appendices

 

Ben Harris-Roxas, Research Fellow - Centre for Health Equity Training, Research and Evaluation (CHETRE)

Phone +61 2 9385 0118 | Fax +61 2 9385 0140 | Email b.harris-roxas@unsw.edu.au
 

For a print copy of the guide and/or more information about HIA please phone +61 2 9835 0129 or email at s.m.green@unsw.edu.au. An online

version of the guide, with additional materials, links to further resources, and online exercises, is being developed and will be released in 2008 on HIA Connect http://www.hiaconnect.edu.au



*      *      *     * 

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.